FORM 20-A

[See Rule 22-A]

REVISION PETITION

BEFORE THE HIGH COURT OF KARNATAKA

Memorandum of Civil Revision Petition under Section 18-A(1) of the Karnataka Tax on Professions, Trades, Callings and Employments Act, 1976.

CIVIL REVISION PETITION No.. . . . . . . . . . . . . . . .OF

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v

. . . . . . . . . . . . . . .. . . . . . . . . . . . . . .Respondent

Revision petition presented to the High Court to revise the order of the Karnataka Appellate Tribunal, dated . . . . . . . . . . . . . . .and passed under Section 17 of the Karnataka Tax on Professions, Trades, Callings and Employments Act, 1976.

1. Assessment year. . . . . . . . . . . . . . .

2. The designation of the officer whose orders were appealed against before the Appellate Tribunal.

3. Date of communication of the order of the Appellate Tribunal.

4. Findings of the Appellate Tribunal.

5. Questions of law raised for decision by the High Court. (Here formulate the questions of law raised concisely).

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Petitioner/s

Authorised Representative, if any.

I/We. . . . . . . . . . . . . . .. . . . . . . . . . . . the petitioner(s) do hereby declare that what is stated above is true to the best of my/our knowledge and belief.

Verified this the. . . . . . . . . . . . . . .day of . . . . . . . . . . . . . . .19. . . . . . . . . . . . . . .

Petitioner(s)

Authorised Representative, if any.